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General NPI Number Information
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NPI Number | 1184546301
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Entity Type | Individual
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Provider Name | RAIZAL LACAYA FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/28/2026
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Last Update Date | 07/28/2026
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Provider Practice Location Address
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Address Line | 7334 S LINDBERGH BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63125-4522
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Country | US
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Telephone | 314-892-8352
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Fax |
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Provider Business Mailing Address
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Address Line | 3534 GRATIOT ST
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City | SAINT LOUIS
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State | MO
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Zip | 63103-2922
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Country | US
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Telephone | 312-560-9367
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2026031918
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License Number State | MO
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